tinnitus C&p For Meniere's- Tinnitus-hearing Loss

[Jim 501st]

I took my discharge hearing report to the va audiologist, and ask if I should file a claim. She advised me I should. The tinnitus is severe, The hearing in my left ear is profound with speech recognition in the 20s.

My right ear is seventy on the pure tone test, speech recognition 80%

The left ear is the one that showed hearing loss when I left the service.

I was diagnosed with Meniere's by an eye, ear and nose specialists at my local va over a year ago, but have piles documentation from the early eighties for treatment for vertigo and dizziness.

The tinnitus is dreadful in both ears and has been since my first vertigo attach in 1984.

I have been treated at the local va for all the above for several years.

I have had good insurance through the years and sent in med records dating back to 1984, including eight hearing graphs that shows a steady hearing loss to the point I am now.

I have sent in c-scans, mri etc that eliminate tumors.

All the above should be in my c-file.

I have a c&p coming on 6 Jan. 08 for the hearing and tinnitus.

I have another on 8 Jan. 08 for Meniere's.

I don't have a clue as to what to expect at these c&p's, but I know many of you do. Perhaps someone could enlighten me. It's time for the big game and I'll admit I am antsy.

Thanks to all

Jim 501 (Old name kkp

[Berta]

Hi Jim- I remember you as kkp-

if you mean the mil discharge certificate it sounds very good for SC here-

here is the C & P exam link as to what you can expect-

http://www.vba.va.gov/bln/21/Benefits/exams/index.htm

Go to Audio exam sheets- I am not sure where the Menerieres C & P is-

and if you go to the BVA web site and put Menireres into the search under 2006 or 2007 some recent decision with the Menireres criteria and Diagnostic codes will pop up and they might help you too.

[rentalguy1]

<H2 style="MARGIN: 12pt 0in 3pt">Here is the worksheet for Meniere's. There is no vestibular assesment required (be thankful), but it will be very beneficial to have had a vestibular assessment in the past with a confirmed diagnosis of Meniere's. If you get a rating for Meniere's, you cannot be rated for tinnitus also. The max you can get for tinnitus is 10%. The max for Meniere's is 100%, but with "average" symptoms you would most likely fall into the 60% category. A audiology C&P is just like any other audiology appointment. Visual check of the canals, pressure test, audiogram, and voice recognition. Be sure they ask about tinnitus during this C&P and make notations as to it's etiology. It is required on the audiology worksheet, and should be granted if the nexus is made, even without filing for it. I just had a audiology C&P at 09:00 today, and I had to show the clown the worksheet, because he didn't even bother to print it off the computer, or have it pulled up on the computer screen to follow. he was working blind, so to speak. Then he wanted to argue over the tinnitus point, even after I showed him his own worksheet. He said the sheet had changed, and I quoted the changes made from the VA Fast letter that wings posted yesterday.These changes actually favor the vet, by the way. He seemed pissed at me, but in the end he said he would do anything he could to help me out. We'll see when I pick up the copy of the C&P next week.

Good Luck!

Worksheet - EAR DISEASE</H2>

Name: SSN:

Date of Exam: C-number:

Place of Exam:

A. Review of Medical Records: Indicate whether the C-file was reviewed.

B. Medical History (Subjective Complaints):

1. Describe history of hearing loss, tinnitus, vertigo, balance or gait problems, discharge, pain, pruritus. State onset and frequency and duration of each, if not constant.

2. Describe current or past treatment for ear conditions.

3. If a malignant neoplasm of the ear is or was present:

a. State date of confirmed diagnosis.

b. State date of the last surgical, X-ray, antineoplastic chemotherapy, radiation, or other therapeutic procedure.

c. State expected date treatment regimen is to be completed.

d. If treatment is already completed, provide date of last treatment.

3. If treatment is already completed, fully describe residuals.

C. Physical Examination (Objective Findings):

1. Conduct an external and otoscopic examination. Address each of the following and describe current findings, including abnormalities of size, shape, or form:

a. Auricle. Any deformity? If there is tissue loss, state whether it is one-third or more of auricle.

b. External canal - describe any edema, scaling, discharge.

c. Tympanic membrane.

d. The tympanum.

e. Mastoids. Discharge? Evidence of cholesteatoma?

f. State all conditions secondary to ear disease, such as disturbance of balance, upper respiratory disease, hearing loss, etc.

2. State whether an active ear disease is present.

3. Infections of the middle or inner ear. Is there suppuration? Effusion? Are aural polyps present?

4. For peripheral vestibular disorders, state the specific diagnosis and its basis, whether there is dizziness and how often, and whether a staggering gait occurs and how often.

5. For Meniere’s syndrome, state the symptoms, including the frequency of attacks of vertigo and cerebellar gait. Is tinnitus present? If so, how frequently and what is its duration? Is there hearing loss? (See audio worksheet.)

6. Describe any complications of ear disease that are present.

D. Diagnostic and Clinical Tests:

1. Include results of all diagnostic and clinical tests conducted in the examination report.

E. Diagnosis:

Signature: Date:

Here is the rating criteria from 38cfr4:

6204 Peripheral vestibular disorders:

Dizziness and occasional staggering........................... 30

Occasional dizziness.......................................... 10

Note: Objective findings supporting the diagnosis of

vestibular disequilibrium are required before a compensable

evaluation can be assigned under this code. Hearing

impairment or suppuration shall be separately rated and

combined.

6205 Meniere's syndrome (endolymphatic hydrops):

Hearing impairment with attacks of vertigo and cerebellar gait 100

occurring more than once weekly, with or without tinnitus....

Hearing impairment with attacks of vertigo and cerebellar gait 60

occurring from one to four times a month, with or without

tinnitus.....................................................

Hearing impairment with vertigo less than once a month, with 30

or without tinnitus..........................................

Note: Evaluate Meniere's syndrome either under these criteria

or by separately evaluating vertigo (as a peripheral

vestibular disorder), hearing impairment, and tinnitus,

whichever method results in a higher overall evaluation. But

do not combine an evaluation for hearing impairment,

tinnitus, or vertigo with an evaluation under diagnostic code

6205.

6260 Tinnitus, recurrent........................................ 10

Note (1): A separate evaluation for tinnitus may be combined

with an evaluation under diagnostic codes 6100, 6200, 6204,

or other diagnostic code, except when tinnitus supports an

evaluation under one of those diagnostic codes.

Note (2): Assign only a single evaluation for recurrent

tinnitus, whether the sound is perceived in one ear, both

ears, or in the head.

Note (3): Do not evaluate objective tinnitus (in which the

sound is audible to other people and has a definable cause

that may or may not be pathologic) under this diagnostic

code, but evaluate it as part of any underlying condition

causing it.

[Jim 501st]

1968 Nam Vet Berta and others.

Meninere's is a tough disease to handle, only yesterday I went to a local Walmart with my wife. As I made a left angle turn I almost landed in an old ladies lap who was in a wheel chair.( If looks could kill). I apologised and told her I wasn't drunk, but she was so old she couldn't hear. The Lady pushing her was familiar with the disease as she has a friend who suffers from the same thing. It is a more than a once a day occurrence with me, so I just laugh it off. However you can't laugh off the constant sickness. When someone ask, I tell them its like being on a carnival ride and can't get off. I'm sure you know what I mean.

My hearing was good when I entered the Military. Its on my service record. When I got out I had significant loss in my left ear. ( Final exam) It's also documented I had dizziness.

I filed a claim and was turned down, Reason, Not service connected.

In their decision none of this was mentioned.

I also had an IMO from a audiologist (that by the way used to do IMO's for the local VA., before they had their own department) that showed a nexus from the time I got out to date. I had lots of evidence from 1980 to date. Including a diagnosis of Meniere's by a VA eye, ear, and nose specialist. All of the above was admitted in their denial, as well as exam from the local VA showing loss in left ear dropping to 95 with 35% speech discrimination. Right. 75 with 70%. and much more.

Like a dummy I appealed it, and then went to see my rep. who's office is in the ro's building.

He couldn't believe they omitted the service connection, and said he would take it up stairs and see if he could get a reconsideration, and then he noticed on the computer I had already appealed it, so it was already in the appeal system and probably be 12 to 14 months before it would be looked at again. This was in September. A few days ago I received a letter from the local VA. I have a C&P in audio on the 5th of Jan. and one on the seventh with a Doctor for ear disease. I am not sure what got the wheels turning so quickly, but am glad it happened.

I also got a decision on a knee injury (Document) and a report on my records that showed it was still swollen and giving me problems 14 Mo's later. The rater missed the latter report and said I had no documented problems after the injury. This was on appeal, so now I have to filed a form 9 to the BVA. However before I file the form nine My rep. is going to see if He can point out their error and get it reconsidered since my case is still at the dro. I am suppose to call him back wed to find out.

I can't believe how unprofessional these people can be, but following 1968 Nam Vet's case I can believe anything.

I did get 50% ptsd on the first round. ( I guess they blew one)

take care all and a Merry Christmas

Jim 501st

[Josephine]

Jim 501st,

When you go for your C&P for the Meniere, show the doctor that you can't walk a straight line.

Do as 1968 Nam Vet, has told you, insist that the doctor write down everything about you in child proof words and ones that a kindergarden child can understand.

Impacting your life, if you are like me, you don't have one.

Hard to be on the social side, when you can't walk into someones' home without falling over the furniture and constantly making excuses for yourself.

From what I have read, I see no way that the VA can deny you.

This disease is one of the most obvious and easy to detect.

Good luck,

I have lived it for so many years, I am not sure that I would know what being normal is.

Always,

Betty

[rentalguy1]

Betty is right, MN is very easy to detect, but almost impossible to get a rating for because there is no clear-cut etiology for the disease. The VA (and the majority of audiologists) still deny that noise exposure causes MN. There is case after case in the BVA and CAVC records that have a final denial due to not being able to make a nexus. If, however, it started while on active duty, and there are SMR's that show the symptoms and treatment recieved, then it is almost impossible for them to deny. Good Luck!

[rentalguy1]

and MN is an extremely hard nexus to make due to no clear etiology.